TY - JOUR
T1 - National surveillance pilot study unveils a multicenter, clonal outbreak of VIM-2-producing Pseudomonas aeruginosa ST111 in the Netherlands between 2015 and 2017
AU - The Dutch CPE surveillance Study Group
AU - Pirzadian, Jannette
AU - Persoon, Marjolein C.
AU - Severin, Juliëtte A.
AU - Klaassen, Corné H. W.
AU - de Greeff, Sabine C.
AU - Mennen, Marcel G.
AU - Schoffelen, Annelot F.
AU - Wielders, Cornelia C. H.
AU - Witteveen, Sandra
AU - van Santen-Verheuvel, Marga
AU - Schouls, Leo M.
AU - Vos, Margreet C.
AU - Bode, L.
AU - Troelstra, A.
AU - Notermans, D. W.
AU - Maijer-Reuwer, A.
AU - Leversteijn-van Hall, M. A.
AU - Kluytmans, J. A. J. W.
AU - Spijkerman, I. J. B.
AU - van Dijk, K.
AU - Halaby, T.
AU - Zwart, B.
AU - Diederen, B. M. W.
AU - Voss, A.
AU - Dorigo-Zetsma, J. W.
AU - Ott, A.
AU - Oudbier, J. H.
AU - van der Vusse, M.
AU - Vlek, A. L. M.
AU - Buiting, A. G. M.
AU - Paltansing, S.
AU - de Man, P.
AU - van Griethuysen, A. J.
AU - den Reijer, M.
AU - van Trijp, M.
AU - van Elzakker, E. P. M.
AU - Muller, A. E.
AU - van der Linden, M. P. M.
AU - van Rijn, M.
AU - Wolfhagen, M. J. H. M.
AU - Waar, K.
AU - Schneeberger, P.
AU - Silvis, W.
AU - Schulin, T.
AU - Damen, M.
AU - Dinant, S.
AU - van Mens, S. P.
AU - van Dam, A.
AU - de Jong, E.
AU - Roescher, N.
AU - Overdevest, I. T. M. A.
N1 - Publisher Copyright: © 2021, The Author(s).
PY - 2021/12/1
Y1 - 2021/12/1
N2 - Verona Integron-encoded Metallo-beta-lactamase (VIM) is the most frequently-encountered carbapenemase in the healthcare-related pathogen Pseudomonas aeruginosa. In the Netherlands, a low-endemic country for antibiotic-resistant bacteria, no national surveillance data on the prevalence of carbapenemase-producing P. aeruginosa (CPPA) was available. Therefore, in 2016, a national surveillance pilot study was initiated to investigate the occurrence, molecular epidemiology, genetic characterization, and resistomes of CPPA among P. aeruginosa isolates submitted by medical microbiology laboratories (MMLs) throughout the country. From 1221 isolates included in the study, 124 (10%) produced carbapenemase (CIM-positive); of these, the majority (95, 77%) were positive for the blaVIM gene using PCR. Sequencing was performed on 112 CIM-positive and 56 CIM-negative isolates (n = 168), and genetic clustering revealed that 75/168 (45%) isolates were highly similar. This genetic cluster, designated Group 1, comprised isolates that belonged to high-risk sequence type ST111/serotype O12, had similar resistomes, and all but two carried the blaVIM-2 allele on an identical class 1 integron. Additionally, Group 1 isolates originated from around the country (i.e. seven provinces) and from multiple MMLs. In conclusion, the Netherlands had experienced a nationwide, inter-institutional, clonal outbreak of VIM-2-producing P. aeruginosa for at least three years, which this pilot study was crucial in identifying. A structured, national surveillance program is strongly advised to monitor the spread of Group 1 CPPA, to identify emerging clones/carbapenemase genes, and to detect transmission in and especially between hospitals in order to control current and future outbreaks.
AB - Verona Integron-encoded Metallo-beta-lactamase (VIM) is the most frequently-encountered carbapenemase in the healthcare-related pathogen Pseudomonas aeruginosa. In the Netherlands, a low-endemic country for antibiotic-resistant bacteria, no national surveillance data on the prevalence of carbapenemase-producing P. aeruginosa (CPPA) was available. Therefore, in 2016, a national surveillance pilot study was initiated to investigate the occurrence, molecular epidemiology, genetic characterization, and resistomes of CPPA among P. aeruginosa isolates submitted by medical microbiology laboratories (MMLs) throughout the country. From 1221 isolates included in the study, 124 (10%) produced carbapenemase (CIM-positive); of these, the majority (95, 77%) were positive for the blaVIM gene using PCR. Sequencing was performed on 112 CIM-positive and 56 CIM-negative isolates (n = 168), and genetic clustering revealed that 75/168 (45%) isolates were highly similar. This genetic cluster, designated Group 1, comprised isolates that belonged to high-risk sequence type ST111/serotype O12, had similar resistomes, and all but two carried the blaVIM-2 allele on an identical class 1 integron. Additionally, Group 1 isolates originated from around the country (i.e. seven provinces) and from multiple MMLs. In conclusion, the Netherlands had experienced a nationwide, inter-institutional, clonal outbreak of VIM-2-producing P. aeruginosa for at least three years, which this pilot study was crucial in identifying. A structured, national surveillance program is strongly advised to monitor the spread of Group 1 CPPA, to identify emerging clones/carbapenemase genes, and to detect transmission in and especially between hospitals in order to control current and future outbreaks.
UR - http://www.scopus.com/inward/record.url?scp=85119137265&partnerID=8YFLogxK
U2 - https://doi.org/10.1038/s41598-021-00205-w
DO - https://doi.org/10.1038/s41598-021-00205-w
M3 - Article
C2 - 34697344
SN - 2045-2322
VL - 11
JO - Scientific reports
JF - Scientific reports
IS - 1
M1 - 21015
ER -